Provider Demographics
NPI:1013996131
Name:BRUNO, AUGUST A JR (MD)
Entity type:Individual
Prefix:DR
First Name:AUGUST
Middle Name:A
Last Name:BRUNO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:3900 N. BUFFALO ROAD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-656-4811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190949-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160056595OtherRR MEDICARE
NY161000580OtherCIGNA
NY161000580OtherGHI
NY00010021601OtherUNIVERA
NY161000580OtherNORTH AMERICAN PREFERRED
NY0707088OtherIHA
NY161000580OtherAETNA
NY000523639001OtherHEALTH NOW
NY161000580OtherEMPIRE PLAN
NY01572816Medicaid
NY161000580002OtherTRICARE
NY01572816Medicaid
NY161000580OtherEMPIRE PLAN